Meth use damages the heart, UH shows

The study of patients at Queen's confirms what doctors knew of the dangers of "ice"

A study of 221 patients at the Queen's Medical Center confirmed what doctors here have long known: Methamphetamine use causes heart trouble.

'Ice' and heart disease study findings

Of 221 patients age 45 or younger who were hospitalized at the Queen's Medical Center between January 2001 and June 2004:

» 107, or 48 percent, had cardiomyopathy, a disease of the heart muscle.

» 40 percent of the 107 patients with cardiomyopathy used methamphetamine. Meth users had 3.7 times the increased incidence of cardiomyopathy than the control group.

» The patients with cardiomyopathy included 70 men and 37 women. Twelve were under age 30; 50, between 30 to 40; and 45, between 40 and 45.

» 21 percent of the patients diagnosed with cardiomyopathy in the study were Caucasian; 29 percent, Asian; and 46 percent, Pacific Islanders.

The risk of cardiomyopathy, a disease of the heart muscle, was nearly four times higher in methamphetamine, or "ice," users than in nonusers, researchers reported in this month's American Journal of Medicine.

"The problem was, for 10 to 15 years everybody knew methamphetamine caused heart failure," said Dr. Irwin Schatz, professor of medicine and cardiologist in the University of Hawaii John A. Burns School of Medicine.

Doctors saw such patients all the time but were told at science meetings that the cases were only anecdotal, he said.

Dr. Khung-Keong Yeo of the University of California-Davis Medical Center in Sacramento said a controlled study was needed, and he and his colleagues conducted it with the UH medical school, Schatz said.

Schatz and Dr. Todd Seto, associate professor of medicine, led the JABSOM team. They reviewed charts of 221 patients age 45 and younger who were hospitalized at Queen's between January 2001 and June 2004.

Of the total, 107, or 48 percent, were discharged with a diagnosis of cardiomyopathy. They were compared with 114 patients of similar ages who were discharged without evidence of heart problems.

Both groups had other medical problems, such as diabetes and hypertension, and included patients who were smokers and used alcohol, marijuana and cocaine.

Forty percent of the 107 patients with cardiomyopathy used methamphetamine.

"The meth users had 3.7 times increased incidence of cardiomyopathy than the control group," Schatz said.

The heart muscle of ice users becomes diseased and begins to lose function, Schatz said: "The heart loses the ability to contract." Many meth users were operating at 30 to 50 percent efficiency, he said.

The most common cause of cardiomyopathy in the past was alcohol, Schatz said. "Now, it's clear that the greatest percentage of people entering the hospital with cardiomyopathy have it because of ice use, and it's a relatively common problem."

"It's another reason to persuade their youngsters from trying ice. It really is devastating to see these folks coming in and out (of the hospital) all the time," Schatz said.

"This is prevalent, I'm sure, all over the country where crystal meth is used," he added. "There is no reason to believe it is unique in Hawaii."

Queen's was selected by Yeo for the study because of a large concentration of patients, Schatz said. Many uninsured patients end up there, he said, "and we were seeing a majority of these patients."

The study is significant because for the first time "it establishes from a scientific point of view that crystal meth can really affect the heart for many of these young users," Schatz said. "It is tragic because many of them won't stop even after they enter the hospital and are discharged. They go back to using again. It's really sad."

Other co-authors of the study at the UH medical school were Dr. Hiroki Ito, Dr. Kevin Tay, Jimmy Efird, Kavitha Alimineti and Chieko Kimata. Dr. Mevan Wijetunga of Washington, D.C., also was a co-author.